The Use of Validated Clinical Outcome Measures in Spinal Surgery: An Analysis of Recent Annual Meeting Abstracts

Background: To assess disease progression in multiple sclerosis (MS) several outcome measures are available. The interrelation of changes on different scales has not been studied extensively and the concept of combining scales has only recently been introduced in MS. Objective: To explore combining different clinical outcome measures in the evaluation of disease progression in MS. Methods: In 553 patients we studied the presence of relevant changes according to standard definitions on the Expanded Disability Status Scale (EDSS), Nine-Hole Peg Test (9HPT), Timed 25-Foot Walk (T25FW) and the Multiple Sclerosis Impact Scale (MSIS-29). We examined ‘exclusive worsening’ (worsening on one measure while not worsening on any other measure) and ‘opposing changes’ (worsening on one measure while improving on another measure). Finally, we investigated the impact of combining assessments. Results: Based on the EDSS alone, 140 patients progressed. However, almost twice as many (275) showed worsening on any of the clinical outcome measures. Exclusive worsening was observed in 37 patients on the EDSS, 13 on the 9HPT, 39 on the T25FW and 44 on the MSIS physical. Of all worsened patients 76 (28%) showed opposing changes, a phenomenon predominantly observed when combining physician-based and patient-derived outcome measures. Conclusion: When assessing disease progression in MS, sensitivity to change can be increased by combining different outcome measures. The added value is especially present when combining measures from different perspectives. However, further research is needed to evaluate the optimal way to combine outcome measures before implementing this strategy in clinical studies.

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Poster 496 Comparison of Patient-Reported Outcome Measures (PROM) to Clinical Outcome and Quality Metrics in Evaluating the Response to the Surgical Management of Lumbar Spine Pathology

PM&R ◽

10.1016/j.pmrj.2014.08.865 ◽

2014 ◽

Vol 6 (9) ◽

pp. S359

Author(s):

Kyle J. Mazellan ◽

Regina Battles ◽

Pradeep Narotam

Keyword(s):

Lumbar Spine ◽

Clinical Outcome ◽

Outcome Measures ◽

Surgical Management ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Quality Metrics ◽

Patient Reported ◽

Spine Pathology

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S.P.21 Clinical outcome measures in Collagen 6 (COL6) and Laminin α2(LAMA2) related congenital muscular dystrophy

Neuromuscular Disorders ◽

10.1016/j.nmd.2012.06.296 ◽

2012 ◽

Vol 22 (9-10) ◽

pp. 893

Author(s):

K.G. Meilleur ◽

M. Jain ◽

E. Kim ◽

L. Hynan ◽

C.Y. Shieh ◽

...

Keyword(s):

Muscular Dystrophy ◽

Clinical Outcome ◽

Outcome Measures ◽

Congenital Muscular Dystrophy ◽

Laminin Α2

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Reduction Osteotomy versus Extensive Release on Clinical Outcome Measures in Simultaneous Bilateral Total Knee Arthroplasty

Medical Science Monitor ◽

10.12659/msm.905815 ◽

2017 ◽

Vol 23 ◽

pp. 3817-3823 ◽

Cited By ~ 1

Author(s):

Pengfei Zan ◽

Lin Fan ◽

Kaiyuan Liu ◽

Yong Yang ◽

Shuo Hu ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Clinical Outcome ◽

Outcome Measures ◽

Knee Arthroplasty ◽

Bilateral Total Knee Arthroplasty ◽

Total Knee ◽

Extensive Release

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The added value of cognition-targeted exercise versus symptom-targeted exercise for multiple sclerosis fatigue: A randomized controlled pilot trial

PLoS ONE ◽

10.1371/journal.pone.0258752 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0258752

Author(s):

Azza Alketbi ◽

Salah Basit ◽

Nouran Hamza ◽

Lori M. Walton ◽

Ibrahim M. Moustafa

Keyword(s):

Multiple Sclerosis ◽

Clinical Outcome ◽

Outcome Measures ◽

Recruitment Rate ◽

Control Group ◽

Entire Study ◽

Randomized Controlled ◽

Significant Difference ◽

Intervention Protocol

Background Fatigue is considered one of the most common symptoms of multiple sclerosis (MS) and lacks a current standardized treatment. Therefore, the aim of this study was to examine the feasibility and effectiveness of a cognition-targeted exercise versus symptom-targeted exercise for MS fatigue. Methods In this Pilot, parallel-group, randomized controlled trial, sixty participants with multiple sclerosis, were randomly assigned to either a Cognition-Targeted Exercise (CTE) (N = 30, mean age 41) or a Symptom-Targeted Exercise (STE) (N = 30, mean age 42). The participants in the experimental group received eight, 50-minute sessions of weekly Cognitive Behavior Therapy (CBT) in addition to a CTE Program; whereas, participants in the control group received eight, 50-minute sessions of weekly CBT in addition to the standardized physiotherapy program (STE Program). Feasibility was assessed through recruitment rate, participant retention, adherence and safety, in addition to clinical outcome measures, including: (1) Modified Fatigue Impact Scale (MFIS), (2) Work and Social Adjustment Scale (WSAS), (3) Hospital Anxiety and Depression Scale (HADS), and Perceived Stress Scale (PSS). All outcome measures were assessed at baseline (pretreatment), following completion of the eight visit intervention protocol, and at 3-months follow-up. Results The recruitment rate was 60% and 93% of participants completed the entire study. The recruited participants complied with 98% of the required visits. No adverse events were recorded. A Generalized Estimation Equation Model revealed a significant difference over time as an interaction term during the post and follow up visit for all clinical outcome measures (p < .001). Conclusion The addition of CTE to CBT exhibited positive and more lasting influence on MS fatigue outcomes compared to Symptom-Targeted Exercise (STE). Feasibility and efficacy data from this pilot study provide support for a full-scale RCT of CTE as an integral component of Multiple Sclerosis fatigue management.

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